Inflammation and Haemostasis in Paraproteinaemias

S ummary . Inflammatory and haemostatic functions were assessed simultaneously in 16 patients with serum paraproteins. Skin window responses were severely depressed in 10; neutrophil phagocytosis was reduced in five. Platelet function was abnormal in 10 and inhibitors of blood coagulation were found in four. Whereas the changes in platelet function appeared to be more concentration‐dependent, abnormal skin window responses occurred at all concentrations of paraprotein. The effect on coagulation and neutrophil phagocytosis appears to be specific for a given paraprotein. Study of isolated γG paraproteins showed this depression of cell function to be markedly concentration‐dependent. Haemostatic defects were corrected by plasmapheresis. Clinical infection and bleeding were prevalent only in patients with levels of paraprotein in excess of 5 g/100 ml, despite abnormal test results at lower concentrations.